Abstract: [This article was originally published in Healthcare Quarterly, 20(3)]Electronic health records (EHRs) and consumer health portals have implications for improving the quality and cost-effectiveness of healthcare and make it much easier for patients and families to access health information in a timely and convenient manner. However, the accessibility of information afforded by EHRs and health portals changes the dynamic of control over health information in very significant ways. Institutions and their clinicians have typically been the caretakers of these documents; therefore, the introduction of portals represents a major cultural shift in healthcare. The efforts of both clinicians and patients are needed to effectively make this shift, as the implementation of new technology is uniquely challenging within a healthcare setting. An interactive workshop was facilitated to understand clinicians' perceived challenges of this shift with a specific focus on the implications of increased transparency and patients' increased access to health information.PubDate: Thu, 14 Dec 2017 05:00:00 +000

Abstract: [This article was originally published in Healthcare Quarterly, 20(3)]Chronic obstructive pulmonary disease (COPD) and heart failure are responsible for significant healthcare costs in Ontario. One program developed to improve the management of these conditions is Telehomecare, which provides six months of health status monitoring and patient self-management education at no cost to participating COPD and heart failure patients. The Toronto Central Local Health Integration Network (LHIN; formerly the Toronto Central Community Care Access Centre), an early participant, enrolled over 3,000 Telehomecare patients between 2012 and 2016. Research shows that the program reduces emergency department visits and hospital admissions, improves patient confidence and self-management skills and is associated with high patient satisfaction. Program improvements and expansion are ongoing.PubDate: Thu, 14 Dec 2017 05:00:00 +000

Abstract: [This article was originally published in Healthcare Quarterly, 20(3)]Medicine is experiencing a paradigm shift, where patients are increasingly involved in the management of their health data. We created a mobile app which permitted parental reporting of immunization status to public health authorities. We describe app use as a proxy for feasibility and acceptability as well as data utility for public health surveillance. The evaluation period ran from April 27, 2015, to April 18, 2017, during which time 2,653 unique children's records were transmitted, containing 36,105 vaccinations. Our findings suggest that mobile immunization reporting is feasible and may be an acceptable complement to existing reporting methods. Measures of data utility suggest that mobile reporting could enable more accurate assessments of vaccine coverage.PubDate: Thu, 14 Dec 2017 05:00:00 +000

Abstract: [This article was originally published in Healthcare Quarterly, 20(3)]Reaching the recipient of online health messages is necessary to Web-based health promotion applications. To measure willingness to adhere to a health-related Web message, we explored the frequency with which more than 13 million Web users ignored or opted to receive a random inbound message. The findings suggest declining curiosity among Web users about online messages, and that certain days may be more propitious than others for communicating with users. This approach can be modified to gather more granular insights into how messages, including timing and design features, can be tailored to promote improved public health messaging.PubDate: Thu, 14 Dec 2017 05:00:00 +000

Abstract: [This article was originally published in Healthcare Policy, 10(3)]Background: Contraceptives are underutilized in Canada, and nearly one in three Canadian women will have an abortion in her lifetime. To help delineate a national family planning research agenda, the authors interviewed healthcare providers and organizational stakeholders to explore their perspective on barriers to contraception across regions of Canada.Methods: Semi-structured interviews were conducted based on validated frameworks for assessing family planning access and quality. The authors purposefully selected 14 key stakeholders from government agencies, professional organizations and non-governmental organizations for in-person interviews. Fifty-eight healthcare providers and representatives of stakeholder organizations in reproductive health who self-selected through an online survey were also interviewed. Transcripts were analyzed for repeated and saturated themes.Results: Cost was the most important barrier to contraception. Sexual health education was reported as inconsistent, even within provinces. Regional differences were highlighted, including limited access to family physicians in rural Canada and throughout Quebec. Physician bias and outdated practices were cited as significant barriers to quality. New immigrants, youth, young adults and women in small rural, Northern and Aboriginal communities were all identified as particularly vulnerable. Informants identified multiple opportunities for health policy and system restructuring, including subsidized contraception, and enhancing public and healthcare provider education. Sexual health clinics were viewed as a highly successful model. Task-sharing and expanded scope of practice of nurses, nurse practitioners and pharmacists, alongside telephone and virtual healthcare consultations, were suggested to create multiple points of entry into the system.Conclusion: Results underscore the need for a national strategic approach to family planning health policy and health services delivery in Canada.PubDate: Mon, 28 Aug 2017 04:00:00 +000

Abstract: [This article was originally published in Healthcare Quarterly, 19(2)]The Scottish Parliament recently passed legislation on integrating healthcare and social care to improve the quality and outcomes of care and support for people with multiple and complex needs across Scotland. This ambitious legislation provides a national framework to accelerate progress in person-centred and integrated care and support for the growing number of people who have multiple physical and mental health conditions and complex needs. Additional investment and improvement capacity is helping to commission support and services that are designed and delivered with people in local communities and in partnership with housing, community, voluntary and independent sectors.PubDate: Wed, 07 Jun 2017 04:00:00 +000

Abstract: [This article was originally published in Healthcare Policy, 12(1)]Canada needs a national strategy to fulfill its obligation to ensure universal access to necessary healthcare, including prescription drugs. A 2004 attempt at a national strategy for pharmaceutical policy failed because it lacked clear vision, logical planning and commitment from federal and provincial governments. The result of uncoordinated pharmaceutical policies in Canada has been more than a decade of poor system performance. In this essay, we present a framework for a renewed national strategy for pharmaceutical policy. Building on published research and international frameworks, we propose that pharmaceutical policies of federal, provincial, and territorial governments be coordinated around a core health-focused goal. We strongly suggest policy actions be taken on four core objectives that are necessary to support the overarching health goal. If implemented, the proposed strategy would offer clear benefits to all Canadians who use medicines, federal and provincial governments and to the economy as a whole. We therefore argue that political leadership is now needed to articulate and implement such a plan on behalf of Canadians.PubDate: Wed, 07 Jun 2017 04:00:00 +000